Disclosures: Kenneth Cusi – Consulting: Merck, Daichi-Sankyo, Roche,

Janssen; Grant/ Research Support: Takeda, Novartis, Mannkind The following find more people have nothing to disclose: Fernando Bril, Marina Kawagu-chi-Suzuki, Reginald Frye, Paola Portillo Sanchez, Maryann Maximos, Song Lai, Jean Hardies, Fermin Tio Background Nonalcoholic fatty liver disease (NAFLD) is becoming the leading cause of chronic liver disease. Predicting mortality risk in individuals with NAFLD remains a major challenge. Vitamin D deficiency (VDD) has been associated with NAFLD and liver fibrosis. It is unknown whether the association between VDD and NAFLD is of any clinical significance. This study examines whether VDD in patients with NAFLD is associated with increased mortality in a nationwide population-based survey of US adults. Methods Data from the Third National Health and Nutrition Examination (NHANES III) and the NHANES III Mortality-linked files were used. To determine the cause of death, the National Center for Health Statistics linked NHANES III participants to the National Death Index registry through December 31, 2006. Analyses were restricted to 4145 adults aged 20-74 years who had serum vitamin D levels

available. Cox proportional regression models were used to examine mortality across quartiles of 25(OH)D concentration among NAFLD patients. Results The prevalence of NAFLD was 33.0%. The prevalence of VDD in patients with NAFLD was 53.7%. In multivariate analyses, female sex, low HDL cholesterol, smoking, non-Hispanic blacks and Mexican Americans were associated with FDA approved Drug Library increased risk of having 25(OH)D <17.6ng/ dl. Having a GFR of >60ml/min, higher albumin, high intensity physical activity and non-winter seasons were associated with a decrease risk of being VDD. The median follow-up time was 14.3(range 1.5-18.1) years. The overall 18-year Kaplan- Meier survival was 79.2%. Survival differed by serum 25(OH) D quartiles; 76.6% for <17.6ng/mL, 72.8% for 17.7-24.2ng/ dL, 80.0% for 24.3-32.1ng/mL and 84.7% for >=32.2ng/ml The majority

of 235(28.3%) deaths occurred Y27632 in patients within the 17.7-24.2 ng/mL quartile of 25(OH)D concentration. Cardiovascular diseases accounted for 40.2%(333) of the deaths while 24.0%(199) were cancer related. Only 22(2.7%) deaths were liver related. Overall, there was no association between all-cause mortality and being in the lower quartiles of 25(OH)D levels(>32.2ng/mL being reference). A trend towards increase mortality was noted with lower quartiles of vitamin D for all-cause and cardiovascular related deaths, but this is not statistically significant. No significant increase in the number of liver related deaths were observed with lower quartiles of vitamin D concentration. Conclusion This study shows that VDD seen in NAFLD is not associated with increased mortality.